While considerable knowledge has accumulated regarding factors that influence the development of non-malignant genitourinary disorders, there are significant gaps that need to be filled. Among these gaps is the need to identify factors that occur early in life and predict diseases or conditions later in life so that the mechanisms of disease can be better understood and for developing prevention strategies. In addition, there is almost nothing known about the subclinical aspects of some putative or known risk factors. The enormous costs in medical care and quality of life for these very common disorders belie the perceived lack of importance for these conditions. To help address these deficits in knowledge, we propose to conduct a study among the participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. This cohort of 5,115 men and women has been followed since 1986 at four field sites with approximately 3,525 of them expect to participate in the Year 25 Exam. From this dedicated cohort comes an incredibly rich longitudinal dataset collected since young adulthood. The overall objective of this study is to examine how factors repeatedly measure over adult life may increase or decrease the presence of benign genitourinary conditions (e.g., urinary incontinence, pelvic organ prolapse, sexual dysfunction, lower urinary tract symptoms, and erectile dysfunction). To accomplish this objective, our primary aims for this proposal are to: 1) determine how modifiable factors are associated with genitourinary outcomes; 2) determine how selected health conditions are associated with genitourinary outcomes; and 4) create a resource to examine the longitudinal relationship between these factors and the onset or progression of these genitourinary conditions. As an exploratory aim we will also examine how biomarkers of inflammatory (e.g., CRP, uric acid, IL-6) and endogenous hormone and binding protein levels are associated with genitourinary outcomes Each outcome will be ascertained using a standardized or well accepted measure that is in common use in epidemiologic or clinical research. We propose to collect two assessments three years apart to examine prevalent, new onset and progression in these conditions. The repeated nature of factors of interest and the types of assessments, many that include assessments of subclinical disease, provide an uncommon opportunity. The next exam cycle for this cohort has been funded and field work with the cohort will begin early in 2010. Thus, the opportunity to include benign genitourinary outcomes in the current assessment is timely and time sensitive. Having such comprehensive data on such a large multiethnic cohort makes this a unique and valuable resource for the study of longitudinal factors and urological outcomes. PUBLIC HEALTH RELEVANCE: The overall objective of this study is to examine how factors repeatedly measure over adult life may increase or decrease the presence of non-malignant genitourinary conditions (e.g., urinary incontinence, pelvic organ prolapse, sexual dysfunction, lower urinary tract symptoms, enlarged prostate and erectile dysfunction). The study will be done among the men and women in the Coronary Artery Risk Development in Young Adults (CARDIA) Study who have been followed since 1986. We hope that by identifying factors affecting genitourinary conditions we can help in the development of primary and secondary prevention interventions.